How much rates vary
Facilitymedian $741 · 10th to 90th $112 to $4,786Professionalmedian $132 · 10th to 90th $95 to $200
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $295.12 Median $1,995.26 Typical High $10,964.78 | Facility | None | $295.12 | $1,995.26 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $309.03 | Professional | None | $107.15 | $141.25 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $4,570.88 | Facility | None | $524.81 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $181.97 | Professional | None | $102.33 | $125.89 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $134.90 | Facility | None | $89.13 | $114.82 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | None | $114.82 | $114.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $1,479.11 | Facility | None | $97.72 | $173.78 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $229.09 | Professional | None | $107.15 | $144.54 | $229.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $1,479.11 | Facility | None | $97.72 | $173.78 | $1,479.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $223.87 | Professional | None | $107.15 | $144.54 | $223.87 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $186.21 | Professional | None | $81.28 | $120.23 | $186.21 |
SummaCare Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $61.66 | Facility | None | $51.29 | $53.70 | $61.66 |
SummaCare Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $173.78 | Professional | None | $102.33 | $141.25 | $173.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $4,677.35 | Facility | None | $501.19 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $204.17 | Professional | None | $95.50 | $131.83 | $204.17 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $53.70 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $21.38 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $107.15 Typical High $109.65 | Professional | 54 · Surgery only | $81.28 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.72 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $100.00 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $75.86 | $100.00 | $102.33 |
Where Ohio sits
The same service costs 4.0 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 45th of 51
$132
AK $437NJ $110
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.